This Telegraph piece is from Liberia at the start of the Ebola outbreak, when catastrophe was looming. Thanks to these undertakers, it didn’t happen. Pictures by Will Wintercross
In calmer times in Liberia, before the fear of Ebola became as feverish as the onset of the disease itself, Cecilia Johnson’s funeral could have been a dignified affair.
But when she died of an unspecified illness on Thursday, her family in St Paul’s Bridge, a slum district of the capital, Monrovia, ignored government edicts to hand her body over for cremation.
Instead, fearing the prospect of being quarantined themselves if they reported it, they sneaked it to the cemetery in neighbouring Tyre Shop Community for burial the following morning.
The problem was that nobody wanted it there. Halfway through the burial, they were confronted by an angry crowd of Tyre Shop residents, demanding to know why a potentially-infected corpse was going in “their” cemetery. A scuffle ensued, and eight hours later, Ms Johnson’s corpse lay parked by the roadside in a rusting, mud-spattered wheelbarrow, covered by a piece of carpet and still seeking a final resting place.
For the two distressed relatives who remained by her side, standing drenched in a tropical storm, it was a case of Not in My Backyard, and Not in My Graveyard either.
Such was the scene that greeted the Liberian government’s new Ebola “burial team” on Friday, as their convoy arrived, sirens blaring, to pick the corpse. Set up specifically to deal with the Ebola outbreak, which has now claimed nearly 1,000 lives across west Africa, theirs is probably the most dangerous undertakers’ job in the world.
Ebola undertakers remove the body of Cecilia Johnson, who is suspected to have died from the virus. Monrovia, Liberia (Will Wintercross)
It is not just the threat of the deadly virus itself, which is still highly contagious in dead bodies. It is also an extremely sensitive issue with locals, for whom a visit from a team in boiler suits and masks is the modern-day equivalent of having an “X” marked on their door during the days of Europe’s Black Death.
“We have been attacked by mobs of people many times,” said the team’s leader, Mark Korvayan, who sports a scar on his shaved head from one recent battle, and whose team is now routinely escorted by the police. “The police escort helps, but this is still a dangerous job.”
In Liberia’s teeming, close-knit shanty towns, the stigma attached to Ebola is considerable. Such is the terror inspired by its horror-movie like symptoms – victims in the latter stages can bleed from their eyes – that many are convinced it is the work of evil spirits, not a virus. Either way, families suspected of losing a loved one to it are often ostracised, as the remaining members of the Johnson family burial party are now learning the hard way.
For the last few hours, a large crowd has been eyeballing them suspiciously, and a Liberian army patrol – called in to break up the earlier scuffling – has stayed on hand hand keep the peace. The other thing that is keeping the two relatives from being physically attacked is the fear that they themselves may both be infected.
“People here have been gathering around and looking at us in a funny way,” complained one relative, as he stood by Cecilia’s body. “It is like they think there is something wrong with us.”
Like many other bereaved families that the burial team visit, he is loathe to admit that the cause of Cecilia’s death could have been Ebola.
His own diagnosis is that she died because of complications from a bullet wound suffered during “World War Three” the Liberian name for the bloody battle in 2003 that brought down the regime of warlord Charles Taylor.
But not surprisingly, the residents of Tyre Shop Community were somewhat sceptical.
“We asked them if they had an official clearance, but they said ‘no’,” said James Zeyzey, 37, the Tyre Shop Community chairman. “So we told them to take the body back, and there was a bit of a fight.
“St Paul’s Bridge, where they come from, is a known Ebola zone. We do not want people to bury bodies in our cemetery – it is already full.”
Like most other people in Tyre Shop, Mr Zeyzey and the Johnson family speak to me in Liberian English, a heavy patois inflected with the vernacular of the freed American slaves who founded the country in the 19th century. But while it is hard to make out some of the words, I have to resist the natural urge to come closer to listen. Ebola is transmitted by bodily fluids such as saliva, and nobody wants the spittle of a victim’s agitated relative landing in their face.
For the burial team, though, close contact with victims is unavoidable. Hence the exhaustive self-protection measures, which include white masks, gloves and white boiler suits, the cuffs of which are bound tightly with masking tape to make sure they are hermitically sealed. Just getting dressed takes around 20 minutes.
“When you pick the bodies up, there is often fluid leaking out of them,” said Mr Korvayan, as he helped a colleague robe up. “You have to be very careful.”
Then begins the task of wrapping Ms Johnson’s in a large plastic shroud and heaving it into a waiting flatbed truck. It is exhausting work, not helped by the fact that in Liberia’s humid temperatures, the airtight suits get so hot inside that they have to be removed every 45 minutes.
That the burial team is even out on the streets is testament to their dedication. Many other Liberian health workers have been too scared to even turn up to work, forcing the closure of parts of its war-shattered health service just when it is needed most.
Liberia is considered the least-equipped of all of the countries affected by the Ebola outbreak, which now also includes Nigeria as well as Guinea and Sierra Leone, and which was on Friday was officially classified as an international health emergency by the World Health Organisation.
When The Telegraph accompanied the burial team on Friday afternoon, they answered five call-outs, most of them to an emergency “bodies hotline” that the government has set up. Reaching each locations in Monrovia’s maze-like shanty towns was a task in itself, and not all the visits went to plan. At the first call, amid the half-flooded alleyways of Rotu Town, a blazing row erupted as the family refused to hand over the body.
The call to the unit had been made by Deacon Steven F Cooper 1st, whose sister had died the afternoon before from what he said was jaundice. However, he had called the team mainly in the hope that they would confirm his diagnosis, and when they said they were there simply to pick up the body, his co-operation ended.
“My sister is not dead from Ebola – if I thought that myself, I would not have come anywhere near here,” Mr Cooper insisted. “We called the hotline all day to get a team to come and clear the doubts of the community, but now that hasn’t happened.”
Other visits, however, suggest the government’s messages are belatedly getting through. At another call, an orderly crowd looks on as the body of Tama Counde Senior, 63, is removed from the shack where he died, less than a week after his wife had also passed away.
Ebola undertakers remove a body of the woman who was suspected of having died from the virus in Monrovia, Liberia (Will Wintercross)
“I don’t know what was wrong with them, but when my mother died, everybody abandoned us, so my father put her body in the casket himself,” said his grieving son Junior, 34. “Maybe a virus crossed into him then.”
Yet families who report deaths do not get much reward for doing the right thing. The bodies are simply taken for immediate cremation, with no testing that might put relatives in the clear. And with Liberia’s health system in ruins, there is little in the way of follow-up help. Junior Counde, for example, complains that nobody in his neighbourhood will now come to visit him, while at the team’s final call of the day, a local tribal chief talks of a vomiting woman living nearby whom everyone is terrified to go near.
“She is throwing up all the time but everyone is scared to go near her,” said Sa Harris, 48. “They need to open the hospitals again.”
The last body to be removed is housewife Shettema Bole, 41, dearly beloved of Tamba Bole, 52, and who died in the small hours of that morning. As the team emerges from her home with her shroud, a song goes up among the local womenfolk, a gentle, choir-like murmur. “Where are you going dear mother, why are you leaving us so young?”
Unlike Ms Johnson in her wheelbarrow, it is a farewell that Mr Bole, who is watching, can be proud of. But with little sign of the Ebola being brought under control, it is one that may ring out many more times yet around St Paul’s.